Abstract
Purpose
Stoma site marking is an important preoperative intervention for preventing various stoma-associated complications. In our institution, standardized stoma site marking is routinely performed before rectal cancer surgery with stoma creation, and various stoma-associated factors are recorded in the ostomy-record template. The present study investigated risk factors for stoma leakage.
Methods
Our stoma site marking is standardized so that it can be performed by non-stoma specialists. To identify risk factors of stoma leakage at 3 months after surgery, various preoperative factors associated with stoma site marking in our ostomy-record template were retrospectively analyzed in 519 patients who underwent rectal cancer surgery with stoma creation from 2015 to 2020.
Results
Stoma leakage was seen in 35 of the 519 patients (6.7%). The distance between the stoma site marking and the umbilicus was less than 60 mm in 27 of the 35 patients (77%) who experienced stoma leakage, so a distance of less than 60 mm was identified as an independent risk factor for stoma leakage. Aside from preoperative factors, stoma leakage was also caused by postoperative skin wrinkles or surgical scars near the stoma site in 8 of 35 patients (23%).
Conclusion
Preoperative standardized stoma site marking is necessary to achieve reliable marking that is easy to perform. To reduce the risk of stoma leakage, a distance of 60 mm or more between the stoma site marking and the umbilicus is ideal, and surgeons need to contrive ways to keep surgical scars away from the stoma site.
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Data availability
The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author (yukiharu.hiyoshi@jfcr.or.jp) upon reasonable request. Data are located in controlled access data storage at the Cancer Institute Hospital of Japanese Foundation for Cancer Research.
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EO, YH, NM, KI, FF, and YF contributed to the conception and design of the study, acquisition, analysis, and interpretation of the data, and drafting and critically revising the manuscript for important intellectual content. TM, TY, TN, and TA contributed to the acquisition of data and critical revision of the manuscript for important intellectual content. All authors have read and approved the final manuscript.
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Drs. Emi Ota, Yukiharu Hiyoshi, Nobuko Matsuura, Kanako Ishikawa, Fumiko Fujinami, Toshiki Mukai, Tomohiro Yamaguchi, Toshiya Nagasaki, Takashi Akiyoshi, and Yosuke Fukunaga have no conflicts of interest or financial relationship to disclosure.
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Ota, E., Hiyoshi, Y., Matsuura, N. et al. Standardization of preoperative stoma site marking and its utility for preventing stoma leakage: a retrospective study of 519 patients who underwent laparoscopic/robotic rectal cancer surgery. Tech Coloproctol 27, 1387–1392 (2023). https://doi.org/10.1007/s10151-023-02839-6
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DOI: https://doi.org/10.1007/s10151-023-02839-6